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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 55 - Chagas' disease

The following occur in Chagas' disease (American trypanosomiasis)
True a. lymphadenopathy
True b. meningoencephalitis

False c. Calabar swelling
True d. mega-oesophagus
False e. saddle-nose deformity

The acute phase may be asymptomatic. There may be a chagoma at the portal of entry. Hepatoslenomegaly and lymphadenopathy may occur in the acute phase. Some deaths occur as a result of cardiac failure and meningoencephalitis. Trypanosomes may be seen on a blood smear. Blood culture and xenodiagnosis increase diagnostic yield. If the diagnosis is made in this stage, treatment with nifurtimox or benzonidazole may reduce parasite numbers and the incidence of late complications.

The intermediate phase is asymptomatic but there is laboratory evidence of infection.

The chronic phase may occur decades after initial infection. Mega-oesophagus and dilated cardiomyopathy are typical.

Calabar swellings occur in loiasis

Saddle-nose deformity occurs in congenital syphilis, lepromatous leprosy and relapsing polychondritis.

Copyright: Rob Skelly 2006